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Saida T.,Kyoto Min iren Chuo Hospital | Saida T.,Institute of Neurotherapeutics | Itoyama Y.,National Center Hospital | Tashiro K.,Hokuyukai Neurological Hospital | And 2 more authors.
Multiple Sclerosis Journal | Year: 2012

Background and objective: Interferon beta (IFNβ) is standard therapy for multiple sclerosis (MS). The efficacy of intramuscular (IM) IFNβ-1a (AVONEX®) was assessed in 25 Japanese patients with relapsingremitting MS (RRMS). Methods: Patients with RRMS not previously treated with IFNβ or other disease-modifying therapies were included in this 36-week study. The primary outcome was the average total number of gadolinium-enhanced lesions detected on four brain MRI scans during the last 12 weeks of 24 weeks treatment with IM IFNβ-1a 30 μg once weekly compared with the number during the 12-week pre-treatment period. Lesions were counted by blinded investigators. Results: IM IFNβ-1a significantly decreased the median number of gadolinium-enhanced lesions from 2.5 to 0.3 (p ≤ 0.0001) compared with pre-treatment values. The median number of new gadolinium-enhanced lesions also decreased significantly from 2.0 to 0.3 (p = 0.0002). Serum neopterin was induced in a manner similar to that observed previously in a Caucasian RRMS population. No new adverse events occurred during the study. Conclusion: This first study of IM IFNβ-1a in Japanese patients with RRMS demonstrated a level of efficacy similar to that reported in Caucasian patients based on an assessment of pre-treatment and post-treatment gadolinium-enhanced lesions. © The Author(s) 2012.

PubMed | Kyoto Min iren Chuo Hospital, Bukkyo University, Kadono Sanjyo Childrens Clinic, Osaka Medical Center and Research Institute for Maternal and Child Health and Tohoku University
Type: | Journal: Pediatric neurology | Year: 2016

The aim of this study is to demonstrate that goal-directed eye-mouth associated movement exists in the newborn and very young infant.The participants were 17 healthy term newborns or very young infants whose ages at the time of the first examination ranged from 1 to 24days. The examiner held the tip of an index finger 20 to 30cm in front of a participants mouth, then suddenly moved it directly toward the mouth. Thirteen of the participants were also examined with the examiners palm as the visual stimulus. The response was judged to be positive if clear mouth opening was elicited as the fingertip or palm was approaching the mouth.In the examinations using a fingertip, the frequency of a positive response as to the total number of examinations in the different age groups within the first twomonths of life ranged between 43.9% and 48.8%, and precipitously decreased to 6.3% at twomonths of age. A positive response was not elicited from age threemonths. On the other hand, in the examinations using a palm, the frequency of a positive response was 5.0% in the newborns, and 6.7% in the infants aged between sevendays and onemonth. A positive response was never obtained from twomonths of age.This study demonstrated that visually guided mouth opening toward an approaching target exists in the human newborn. The eye-mouth associated movement may be controlled through rudimentary but functional visuomotor circuits in the brain interconnecting different cortices.

Einspieler C.,Medical University of Graz | Hirota H.,St Josephs Hospital Kyoto | Yuge M.,Kyoto Prefectural Chutan higasi Public Health Office | Dejima S.,Kyoto Min iren Chuo Hospital | Marschik P.B.,Medical University of Graz
Developmental Neurorehabilitation | Year: 2012

Objective: There is little systematic data on early neurodevelopmental functioning of infants with Smith-Magenis syndrome, since early diagnosis is rare. Methods: A boy with cytogenetically confirmed Smith-Magenis syndrome was videotaped at 4 months and 1 week of age. His posture and spontaneous movements were analysed without knowing the diagnosis. Results: The motor repertoire appeared significantly reduced; fidgety general movements, which are typical of that age, were missing. Posture was abnormal and overall movements were jerky and monotonous. The findings indicate a severe motor impairment by no more than 4 months of age. Conclusion: It was concluded that an absence of fidgety movements that goes along with subtle dysmorphic features indicates an increased risk of maldevelopment and justifies the need to refer for genetic evaluation with the potential of facilitating earlier diagnosis. © 2012 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

Kambayashi T.,Kyoto Min iren Chuo Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

A 60-years-old man was presented with the posterior mediastinal tumor by chest computed tomography (CT) that had been taken for the examination of another disease. A well circumscribed mass of 9 x 6 x 5 cm in diameter between the body of the thoracic vertebra and pericardium and a well circumscribed mass of 2 x 2 x 0.8 cm in diameter in the 9th intercostal space were noted by chest CT. von Recklinghausen's disease was suspected by the presence of a lot of brown spots and subcutaneous small nodules in the whole body, and both was speculated as neurogenic tumors. Both tumors were removed by the operation, and the pathologic diagnosis of the neurofibroma was obtained.

Kambayashi T.,Kyoto Min iren Chuo Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

Segmentectomy including the sequestrated segment and lobectomy are generally performed for intralobar pulmonary sequestration. We report a case of intralobar pulmonary sequestration of Pryce type III treated by resection of only the sequestrated segment. A 57-year-old man presented with a 5 x 3 cm mass shadow overlapping a cardiac shadow on the left lower lung field on chest radiograph at medical examination. The mass was not connected with the bronchial tree, and was supplied by an aberrant artery arising from the thoracic descending aorta. The mass was suspected to exist in the normal visceral pleura from chest images. The mass was suspected to be an intralobar pulmonary sequestration from the abovementioned findings, and we performed an operation. At the beginning of the procedure, after dissecting the aberrant artery, only the sequestrated segment was performed.

Kambayashi T.,Kyoto Min iren Chuo Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2012

A 74-year-old man underwent right upper lobectomy for the lung cancer and bullectomy of right lower lobe. Fibrin sealant was used for sealing the excision line. The increase of the pleural effusion with increasing C-reactive protein( CRP) and eosinophilia was noted at the 17th day after the operation. The pleural effusion was transparent and yellowish colored suggesting transudatory liquid. The eosinophil in the pleural effusion was as high as 14%. The drainage of the pleural effusion was performed for 2 days resulting in disappearing the abnormal accumulation without any additional treatment. The cause of pleural effusion was supposed to be fibrin sealant by a positive result of the drug lymphocyte stimulation test.

Kambayashi T.,Kyoto Min iren Chuo Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2014

The purpose of this study is to clarify the postoperative change of pericardial fat pad used in pulmonary resection to reinforce bronchial suture or bronchial stump. 5 cases who received chest computed tomography (CT) examination 2 times or more after the operation (once within one week after the operation) were enrolled. For evaluation, scoring system from 1 to 4 according to the percentage of remaining pericardial fat pad was applied(1 point: 0∼19%, 2 point: 20∼49%, 3 point: 50∼79%, 4 point: 80∼100%). At 1 to 2 months after the operation, almost all cases were 3 or 4 point. However, the scores declined to 1 or 2 point 5 months after the operation in almost all cases. It is likely that the pericardial fat pad remains to be effective in protecting bronchial stump or anastomosis 1 to 2 months after the operation.

Study Objective. To assess the usefulness of virtual images of the visceral pleura in identifying the localization of peripheral small pulmonary nodules intraoperatively. Study Design. We examined 12 cases with 12 peripheral small pulmonary nodules between 2008 and 2010. All lesions were predicted to be difficult to identify during surgery, and virtual images of the visceral pleura were made and evaluated before surgery. We predicted the usefulness of virtual images of the visceral pleura in identifying the localization of peripheral small pulmonary nodules. Results. The mean maximum dimensions were 10.5 ± 4.36 mm. The mean depth from the visceral pleura was 4.0 ± 4.67 mm. The lesions were the solid type in 6 cases and the ground-glass opacity type in 6 cases. In 7 cases primary lung cancer was present, while the other 5 cases had only benign lesions. In all cases, changes in the visceral pleura could be identified with virtual images of the visceral pleura before surgery. We identified 7 lesions out of 12 intraoperatively. The reasons for the failure to identify the lesions were an inability to adequately observe the visceral pleura because of pleural adhesion, or failure to perform single lung ventilation in 3 cases. Another reason was that the changes in the visceral pleura were too minor to identify intraoperatively (2 cases). Conclusion. Virtual images of the visceral pleura may be useful for identifying the localization of peripheral small pulmonary nodules, and the prediction of whether or not the identification of lesions is possible intraoperatively, without preoperative marking in order to identify peripheral pulmonary nodules. © 2011 The Japan Lung Cancer Society.

Kambayashi T.,Kyoto Min iren Chuo Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

We carried out right upper lobectomy and mediastinal node dissection for a 67-year-old man with lung adenocaricinoma in the right upper lobe. Intraoperatively, we found the middle lobe vein, V2, and V3 in front of the pulmonary hilum, and did not found a part of the right apical pulmonary vein. We found a part of the right apical pulmonary vein placed between the right main pulmonary artery and the right upper lobe bronchus, after cutting the pulmonary artery branches to the right upper lobe. We should keep on mind the possibility of anomalous course of pulmonary vein when pulmonary surgery is planned. And, if this abnormality is doubted with the preoperative chest computed tomogrphy (CT) scan, threedimensional CT( 3D-CT) scan of the pulmonary vein is useful.

Tanaka M.,Utano National Hospital | Tanaka M.,Kaikoukai Josai Hospital | Tanaka M.,Kyoto Min Iren Chuo Hospital | Tanaka K.,Niigata University
Journal of Neuroimmunology | Year: 2016

Sudden hearing loss may occur in rare cases of relapsing-remitting multiple sclerosis (RRMS). There have also been reports of idiopathic sudden sensorineural hearing loss (SNHL) in patients with neuromyelitis optica spectrum disorders (NMOSD), but the frequency of such cases is unclear. We conducted a retrospective analysis of the medical records of 173 consecutive patients with multiple sclerosis (MS) and 101 consecutive patients with NMOSD who tested positive for anti-aquaporin-4 antibodies in addition to 37 consecutive patients with clinically isolated syndromes (CIS) to investigate the frequency and onset timing of SNHL. SNHL was observed in six (3.5%) of the RRMS cases, one (1.0%) of the seropositive NMOSD cases, and three (8.1%) of the CIS cases. SNHL occurred ahead of onset in 4/6 MS patients and in all of 3 CIS patients. Patient with NMOSD exhibited SNHL 6 years after the onset of NMOSD. Although SNHL is rare, these results suggest the risk of developing demyelinating lesions in the central nervous system and further conversion to MS in the future. © 2016

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